Healthcare

October 19, 2018

Following an unrelenting seven-year battle waged by Congressional Republicans to repeal/de-fund/delay/alter former President Obama’s signature domestic policy and legislative achievement and the sweeping Republican victory in the 2016 elections, the GOP effort to repeal and replace the Affordable Care Act (“ACA” or “Obamacare”) fell dramatically short during the 115th Congress’ first session (although subsequent enactment of the Tax Cuts and Jobs Act includes repeal of the ACA’s individual mandate penalties).

In the aftermath of an initial false start, the House of Representatives in May 2017 passed the American Health Care Act (“AHCA”) by a vote of 219 to 213 (with 20 Republicans joining all 193 Democrats in opposition).

Senate Republicans were not able to produce a bill capable of garnering the 51 votes needed for passage, and the legislative process aimed at repealing and replacing Obamacare came to a grinding halt prior to Congress’ annual August/Labor Day/ District work period.

Nonetheless, progress was made on building support for several issues long on the NAW agenda in this space. For example, the House-passed AHCA included:

Elimination of the employer mandate penalties applicable to employers with 50 or more full-time employees.

Extension of the delay in implementation of the 40% excise tax on high-cost employer-sponsored health plans (the “Cadillac Tax”).

Full repeal of the annual fee on health insurance providers (the “health insurance tax” or “HIT”).

Of crucial importance was the absence of any limitation on the exclusion from income of the value of employer-sponsored health benefits.

Two additional NAW-supported health bills passed the House in the spring: the Small Business Health Fairness Act authorizes the formation and multi-state operation of both self-funded and fully-insured association health plans (“AHP”); and the Self-Insurance Protection Act (“SIPA”) shielding stop-loss insurance from being regulated as health insurance. SIPA’s enactment would reaffirm long-standing policies to ensure employers can continue to offer workers flexible, more affordable health care plans through self-insurance. The FY ’18 Continuing Resolution enacted on January 22nd included two items of particular concern to NAW members: a hiatus in application of the Health Insurance Tax (HIT) for 2019, and an extension to 2022 in the delay of implementation of the Cadillac Tax.

The focus of more recent activity in the Obamacare space has surrounded a desire to stabilize the ACA exchanges. The effort to include a stabilization package in the FY ’18 Omnibus Appropriations Bill enacted on March 23rd came up short. NAW’s focus is fixed on securing an additional pause in the HIT by bringing it forward to 2018 and extending it to 2020.

Recently, the House passed a bi-partisan bill which included a two-year delay of the Health Insurance Tax (HIT) for 2020 and 2021. NAW will continue working with the Senate by urging them to take up this two-year delay as soon as possible and provide small business employers with the immediate and necessary cost savings of as much as $570 on average in the small group market.

The Stop The HIT Coalition, of which NAW is an active member, spearheaded a letter to House Leadership earlier this month urging immediate action to protect our small businesses and to delay and ultimately repeal the HIT once and for all.

Additionally, in June, NAW joined over 200 businesses and national, state, and local organizations in sending a letter to both the House and Senate supporting H.R. 3919, Commonsense Reporting Act. The bill provides consumers with help during the annual health coverage open enrollment process, employers with relief from the burdensome reporting requirements, and Exchanges with an additional tool to verify tax credit and subsidy eligibility. The Partnership for Employer-Sponsored Coverage Coalition, which NAW helps manage, spearheaded the letter to ensure that employer-sponsored coverage is strengthened and remains a viable, affordable option for millions of American workers and their families for decades to come.